Zyban

Brand Name:Novo-Bupropion SR, Wellbutrin SR

Prescription needed: Yes

What is this drug used for?

Bupropion is primarily used to help people break their addiction to tobacco and quit smoking. It can also be used to treat the symptoms of depression.

When you are feeling symptoms of depression, the chemicals in your brain are not working as well as they should or you may not have the correct amount of a certain chemical to keep things in balance. Bupropion works by trying to balance the amount of these chemicals in the brain to help decrease the feelings of depression.

To help you stop smoking, these same chemicals may influence your cravings for cigarettes. Bupropion may work to decrease your cravings for cigarettes and help you to quit smoking.

Is there any reason not to take this drug?

You should not use this medication if you are allergic to bupropion, have an eating disorder such as bulimia or anorexia, if you are trying to quickly stop drinking alcohol or taking some medications (e.g. diazepam, lorazepam, and other benzodiazepines), or if you have seizures. Before taking this medication, tell your doctor if you have or have ever had:

  • a problem with alcohol or drug abuse
  • feelings of worsening depression or thoughts of suicide
  • A condition called bipolar disorder
  • difficulty sleeping
  • problems with your liver or kidney
  • tried to stop smoking before
  • a serious injury to the head
  • high blood pressure

What about possible side effects?

The most common side effects to bupropion include:

  • difficulty sleeping
  • headaches
  • nausea and not feeling hungry
  • dry mouth
  • shaking hands
  • rash

These side effects are usually related to dose, the use of other medications and other factors (e.g. older age, other medical conditions). As well, some of these symptoms tend to go away within a few weeks of starting treatment and, in most cases, aren't serious enough to cause people to stop taking bupropion. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects. Contact your doctor if these symptoms continue or become worse.

Other less common and possibly severe side effects include:

  • itchy skin
  • high blood pressure (rare)
  • feeling confused
  • feeling anxious
  • seizures (rare; risk increases with higher doses and other factors; talk to your doctor or pharmacist about whether you have any risk factors)
  • Rare cases of hepatitis (inflammation of the liver) or jaundice (yellowing of skin and eyes) have been reported - call your doctor if you experience unexplained nausea, vomiting, stomach pain, fatigue, loss of appetite, dark urine, yellowing of the skin and/or eyes

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

Health Canada has issued a special advisory that says people of all ages who take newer antidepressant drugs may experience behavioural and emotional changes that may increase the risk of suicide. (See “Other Information” section).

Read: Health Canada advises Canadians of stronger warnings for SSRIs and other newer anti-depressants

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact and may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely.

  • phenelzine, tranylcypromine, moclobemide, other MAO-I inhibitors, and thioridizine – avoid the use of these drugs together; must wait 3-14 days after stopping one before you can start the other, talk to your pharmacist or doctor
  • other medications for depression or schizophrenia - may see increase chance for some side effects
  • carbamazepine, rifampin, phenobarbiatal, phenytoin - may decrease the amount of bupropion in the blood
  • amantadine
  • cyclophosphamide
  • levodopa
  • lithium
  • ritonavir
  • theophylline
  • paroxetine, fluoxetine, metoprolol, imipramine, amitriptyline, desipramine: bupropion may increase the amount of these drugs in the blood

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications

Other information:

If you are taking this medication for depression: It takes several weeks (four to six weeks) before this medication will even start to work. Do not stop this medication if you feel it is not working. Your doctor will follow you and adjust the dose over time to find the right dose. Sometimes people feel worse in the beginning and want to stop their medication. This is usually due to side effects, which tend to go away with time. However, if you feel any of the following symptoms, contact your doctor right away:

  • new or worsening feelings of depression
  • thoughts of suicide
  • extreme worry
  • agitation or panic attacks
  • aggressive behavior
  • acting without thinking
  • severe restlessness
  • frenzied abnormal excitement
  • any other sudden or unusual changes in behavior

If you are taking this to help you stop smoking: Zyban is taken for a two-month treatment course, and works best if you also use a support program. You can call the: Canadian Cancer Society’s Smokers Helpline (1-877-513-5333, toll free from anywhere in Ontario). Quit specialists are available to take calls - usually right away - Monday to Thursday, 8 a.m. to 9 p.m., and Friday, 8 a.m. to 5 p.m. During other times, or when the quit specialists are busy, callers can leave a message and have their call returned quickly.

Children: Not recommended for children.

Seniors: May need to take a reduced dose. Ask your doctor.

Pregnant women: Safety in pregnancy has not been fully established. Not treating the depression is often worse than the possible effects of the medication Talk to your doctor.

Women who are nursing: This drug passes into breast milk. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know the impact this drug has on them personally.

Overdose: Too much of this medication can significantly increase your chances of experiencing a seizure. If you experience any unusual reactions or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug. Do not stop taking a drug until you have spoken to a doctor first. He/she may want you to decrease your dose slowly.

If you miss a dose: Take it as soon as you remember. If the next dose is scheduled within two hours, take a single dose and skip the next scheduled dose. Never double the dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom); always out of reach of children.

Dietary precautions: None.